Resource Guide for Providers' Front Desk Staff

The Iowa Medicaid Enterprise (IME) has put together a useful tool for administrative staff which includes important phone numbers, claims submission information and more.

Download and print the Managed Care Quick Reference Guide here.

Coverage has Begun!

After more than a year of preparation, hard work and unprecedented cooperation among Iowa Medicaid, its stakeholders and federal partners, IA Health Link coverage has begun.

 

Iowa's most vulnerable populations now have a healthcare delivery system focused on better coordination and improved quality of care. They have access to health plans with the latest technology, providing new benefits beyond what Medicaid has traditionally offered. While this is a significant step forward for members, this is also a much-needed step toward a more predictable and sustainable budget for our taxpayer-funded program.

 

Read the full letter from Iowa Medicaid Director, Mikki Stier, here.

Verify Eligibility

The Eligibility and Verification Information System (ELVS) line is very busy during the first of the month. The ELVS web portal  is another option for providers in lieu of calling the ELVS line but each provider must enroll through the Electronic Data Interchange Support Services (EDISS).

 

Prior Authorization Requirements 

The Iowa Medicaid Enterprise (IME) has put together a prior authorization (PA) summary by plan. Quickly view and compare PA requirements for each plan with this easy-to-use chart.

Download and print the PA requirements by plan here.

Special Hours for Managed Care Transition

The Iowa Medicaid Enterprise (IME) will have call center staff available Saturday, April 2, 2016, from 8 a.m. to 5 p.m. to assist members and providers with the transition to managed care. The Managed Care Organizations will also have special hours, please see below.

Amerigroup Iowa, Inc.

Non-Emergency Medical Transportation

Managed Care Organization Provider Resource Pages Available

New Provider Informational Letters

The Iowa Medicaid Enterprise has posted several important informational letters to assist with the launch of the IA Health Link managed care program.

Informational letters are posted through the Iowa Medicaid Portal Application (IMPA) system and are available on the DHS website here. Recent informational letters are featured below. 

These letters communicate important policies and procedures for providers and their administrative staff. Providers should continue to watch closely for updates during the implementation period. 

• 1635-MC Electronic Billing

• 1638-MC Update - 340B Drug Pricing Program

• 1639-MC Mental Health and Substance Abuse Services Billed on the UB-04

• 1642-MC Reimbursement for Vaccines for      hawk-i members

• 1643-MC Incident Reporting Notice

• 1644-MC Medicaid Preferred Drug List for Medicaid and hawk-i members

• 1645-MC Enrollment and Payment Policies for PA Services

• 1649-MC Lock-In (LI) Program for Medicaid Fee-for-Service (FFS) Members

• 1652-MC Billing for Hospital Services

• 1653-MC Tobacco Cessation Coverage and the IA Health Link

• 1655-MC Updates for Psychiatric Medical Institutions for Children (PMIC)

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